Global health emergency declared for Mpox

The World Health Organisation (WHO) Director-General Dr Tedros Adhanom Ghebreyesus has determined that the upsurge of mpox in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa constitutes a public health emergency of international concern (PHEIC) under the International Health Regulations (2005) (IHR).

Dr Tedros's declaration came on the advice of an IHR Emergency Committee of independent experts who met earlier in the day to review data presented by experts from WHO and affected countries. The Committee informed the Director-General that it considers the upsurge of mpox to be a PHEIC, with potential to spread further across countries in Africa and possibly outside the continent.

In declaring the PHEIC, Dr Tedros said, "The emergence of a new clade of mpox, its rapid spread in the eastern DRC, and the reporting of cases in several neighbouring countries are very worrying. On top of outbreaks of other mpox clades in the DRC and other countries in Africa, it is clear that a coordinated international response is needed to stop these outbreaks and save lives."

This PHEIC determination is the second in two years relating to mpox. Caused by an orthopoxvirus, mpox was first detected in humans in 1970, in the DRC. The disease is considered endemic to countries in central and west Africa.

In July 2022, the multi-country outbreak of mpox was declared a PHEIC as it spread rapidly via sexual contact across a range of countries where the virus had not been seen before. That PHEIC was declared over in May 2023 after there had been a sustained decline in global cases.

Mpox has been reported in the DRC for more than a decade, and the number of cases reported each year has increased steadily over that period. Last year, reported cases increased significantly, and already the number of cases reported so far this year has exceeded last year's total, with more than 15,600 cases and 537 deaths.

The emergence last year and rapid spread of a new virus strain in the DRC, clade 1b, which appears to be spreading mainly through sexual networks, and its detection in countries neighbouring the DRC is especially concerning and one of the main reasons for the declaration of the PHEIC.

Several outbreaks of different clades of mpox have occurred in different countries, with different modes of transmission and different levels of risk.

The two vaccines currently in use for mpox are recommended by WHO's Strategic Advisory Group of Experts on Immunisation and are also approved by WHO-listed national regulatory authorities, as well as by individual countries including Nigeria and the DRC.

The Director-General triggered the process for emergency use listing for mpox vaccines, which will accelerate vaccine access for lower-income countries that have not yet issued their own national regulatory approval. Emergency Use Listing also enables partners, including Gavi and UNICEF, to procure vaccines for distribution.

WHO is working with countries and vaccine manufacturers on potential vaccine donations and coordinating with partners through the interim Medical Countermeasures Network to facilitate equitable access to vaccines, therapeutics, diagnostics, and other tools.

To allow for an immediate scale-up, WHO has released US$ 1.45 million from the WHO Contingency Fund for Emergencies and may need to release more in the coming days. The organisation appeals to donors to fund the full extent of the needs of the MPOX response.

Source: World Health Organisation